How to clean nebulizer supplies?

I think many of us change our cleaning over time. One important thing, IMO, is that those with more mucus need to be a bit more vigilant in cleaning. I seldom bring up mucus, therefore rinse rather than scrubbing/soaking in soapy water before sterilizing.
I started with boiling the nebulizer and aerobika. A year or two ago, I got a baby bottle sterilizer and I use it for my silicone nasal rinse bottle, the nebulizer, measuring cup, toothbrushes and the jars I use to hold the sterilized distilled water. I run the bottle sterilizer every day or two. I love it. I also use the sterilizer bag the sinus bottles after second use of day. The bags only sterilize 2-3 minutes which may not be long enough to kill some things, but I figure it’ll clean them and the longer bottle sterilizer will prevent biofilm development.

I use vinegar for the spacer and handheld water pik tubing and little tank, but admittedly do that less than I should (prob should 2x/week but have seen no data). I melted a water pik tank bottle sterilizer, as well as 1 toothbrush, but usu toothbrushes are ok.

My doc said I can try nebbing a few times/week since PFT’s are good/stable and scant secretions. I’m still trying to establish a new routine (harder than I expected) and that’ll change cleaning again.

@carolmj @bronchiectasaurus @pacathy @grammyvictoria @legacygsh1 @rockinkranch @jackie7926 @nickraosr @melinda561 @smc17
Hello all, I have been watching this conversation develop for several days. How, how much, and how often to clean nebulizer equipment, spacers, Aerobika and similar devices, and nasal lavage equipment is a HUGE topic on all of the Bronchiectasis discussion groups, and even among experts.
Y'all have heard far too much from me over time about what I do and why, and many of you know I am on the high end of risk tolerance, so I'm noy adding my unscientific opinion here.

But, STAY TUNED FOR FURTHER INFORMATION. By way of the NTM Info organization, two noted experts in the field, Dr Jennifer Honda and Dr Joe Falkinham and their staff are testing various cleaning and sterilization methods, and hopes to release a definitive report soon.

In the meantime, washing/soaking alone is not enough to eliminate NTM and other pathogens, especially if you already have an infection. But, it is "up in the air" whether daily sterilizing is necessary, how long to boil, which baby bottle sterilizers or microwave bags are best, whether you need to dry the parts after sterilizing, whether vinegar or alcohol work (and at what concentration/for how long.)

Regardless of what you may read on other forums, I'm sorry there is no single answer right now, but be patient.

I neb once a day and have 4 Pari eRapid handset sets. After each use I take apart the handset and rinse every part under hot tap water, then put them in a mesh colander/bowl with a lid (to keep my cats from fishing out the blue silicone valves, which they think are toys) to dry. On the fourth day, after rinsing as usual, I soak the aerosolizing mesh parts in soapy water for 5-10 minutes while I bring a pot of distilled water to boil. I rinse off the soap, put the mesh parts back with everything else, dump the lot into the boiling distilled water and simmer for 11 minutes. Then I remove everything with tongs and place in a bottle sterilizer I use only for drying, and use the 40-minute dry cycle.

I replace the distilled water every 1-2 weeks.

Until recently I used 2 handsets and boiled every other day; I'm just starting this every-4-days system. So far I am relieved to only have to boil half as often. I'm clawing back time wherever I can.

@sueinmn Dr Joe has said many times that we need to boil for a minimum of 10 minutes and 1 additional minute for every 1000 feet. I feel that, for me at least, that is the most effective method. I then put the parts in a Grownsy baby bottle sterilizer for the full auto treatment which includes a long drying time and then UV, even if the UV use is argued about.

@bronchiectasaurus Just curious: The manufacturer (Pari) recommends replacement at 6 months. But you are rotating 4 sets, so can you go longer than 6 months before replacing? I only neb once a day at this point. But some people neb twice a day or more, so presumably the more cleaning and sterilizing required, would reduce the life of the equipment. I have two pari sets and I soak, rinse, and sterilize after each use. I do the same daily with the aerobika.

@bronchiectasaurus Just curious: The manufacturer (Pari) recommends replacement at 6 months. But you are rotating 4 sets, so can you go longer than 6 months before replacing? I only neb once a day at this point. But some people neb twice a day or more, so presumably the more cleaning and sterilizing required, would reduce the life of the equipment. I have two pari sets and I soak, rinse, and sterilize after each use. I do the same daily with the aerobika.

@bronchiectasaurus Just curious: The manufacturer (Pari) recommends replacement at 6 months. But you are rotating 4 sets, so can you go longer than 6 months before replacing? I only neb once a day at this point. But some people neb twice a day or more, so presumably the more cleaning and sterilizing required, would reduce the life of the equipment. I have two pari sets and I soak, rinse, and sterilize after each use. I do the same daily with the aerobika.

I have two neb cups and 2 Aerobikas in constant rotation. I neb with Aerobika 2x day. I soak in Dawn antibacterial water at least 15 mins, rinse, put in Instapot 12 minutes at pressure cook then dry in Wabi dryer 70 minutes. This works for me as I have the dedicated Instapot and Wabi UV dryer in the room where I do airway clearance.